Dr. Raja Flores

When Dr. Raja Flores announced that removing just part of the pleural membrane was as effective as removing the entire lung in pleural mesothelioma patients, he turned the medical community upside-down. Some believed he was violating longstanding rules that the best treatment for all early-stage asbestos-cancer patients was removing the whole diseased lung.

Flores is the chief of thoracic surgery and director of the Thoracic Surgical Oncology Program at Mount Sinai Medical Center in New York. In his landmark study, “Extrapleural Pneumonectomy versus Pleurectomy Decortication in the management of malignant pleural mesothelioma," he showed that removing only part of the pleura could help with long-term survival rates. This 2008 study has become one of the most frequently cited studies featured in “The Journal of Thoracic and Cardiovascular Surgery.”

Flores won’t rule out other procedures. He said that both a pleurectomy decortication and an extrapleural pleurectomy are good choices for some patients. A pleurectomy decortication removes the damaged pleura around the lungs and an extrapleural pleurectomy removes the damaged lungs and surrounding lining.

What are Flores’s Specialties?

During a recent symposium, Flores said the main treatment regime for asbestos-cancer patients is chemotherapy, an extrapleural pneumonectomy and high-dose radiation. However, he’s a proponent of saving the lung through a pleurectomy.

“Whenever you can save the lung, in my opinion, that’s the way to go,” he said. “When I can’t remove all the tumors by a pleurectomy, then I do an extrapleural pnemonectomy. The majority of patients will need an extrapleural pnemonectomy.”

In addition to being a world-renowned surgeon who specializes in asbestos cancers, lung cancer and esophageal cancer, Flores is a medical researcher with a focus on asbestos-related areas. He has pioneered several practices that are commonly used today to treat asbestos cancers, including intraoperative chemotherapy. His research has led to clinical trials, including one that looked at the use of the two medications gemcitabine and cisplatin following invasive surgery and another that looked at the use of high doses of radiation to treat the disease.

Flores has authored more than 150 peer-reviewed journals, books, manuscripts and book chapters and has given dozens of lectures worldwide. He also keeps a database of asbestos-cancer patients to help further research efforts and look for problem areas in treatment.

He is also known worldwide for the minimally invasive VATS (Video Assisted Thoracic Surgery) procedure for lung cancer. Flores is so skilled at the VATS procedure that he implemented the program for it to be used at Memorial Sloan-Kettering Cancer Center in New York. He also published two studies that showed the procedure had fewer complications than invasive surgeries and resulted in quicker hospital stays.

Flores’s Background

Born and raised in Manhattan, Flores worked a variety of jobs before going to medical school, including doorman, deli clerk and package deliveryman. He spent a lot of his youth in the boxing ring as a way to get street cred in his tough New York neighborhood.

Flores graduated from New York University with his bachelor’s degree and received a medical degree from the Albert Einstein College of Medicine in New York. After his residency, Flores completed a thoracic oncology fellowship and cardiothoracic surgery residency at Brigham and Women’s Hospital in Boston, where Dr. David Sugarbaker is the head of the thoracic surgery department. Flores also graduated from Columbia University with a Master’s degree in biostatistics.

Flores said he developed a deep interest in thoracic surgery and asbestos-related cancers after discovering he liked understanding the anatomy of the chest. For more than a decade, he held a variety of positions at Memorial Sloan-Kettering, including associate professor of cardiothoracic surgery. When he was named the chief of thoracic surgery at the Mount Sinai Cancer Center, hospital officials called him a “technically superb surgeon,” and noted he has one of the lowest complication rates nationwide with the esophagectomy, a surgery to remove the esophagus used mainly in esophageal-cancer patients.

Flores is active in several professional organizations, including The Society of Thoracic Surgeons and the American Association for Thoracic Surgery.